002886 (SFD)Building 55 U 2=1 �ZS
Address
P.O. BOX 1504 NQ.: 002886
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
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Mailing '
Address
City VeSertlZip Tel. -2828 922 568
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Contractor
intim I irk and Imil
Address
City Zip" Tel:
BUILDING: TYPE -CONST. OCC: GRP.
A.P. Number
Legal Description
FM
Project Description Im VMM 14
1 M
State Lic.
City
Uri 1.330
& Classif..2$81301
Lic. # ,
Sq. Ft.
No. No. Dw.
Size 424
Stories- - . Units
Arch.; Engr.,• ... .. .....
Designer
New a Add ❑
Alter ❑- Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
.. . .
Lic. # _
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that.l am licensed under provisions of Chapter 9 (commencing -with Section
7000) of Division 3 of the°Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
'
An Mt.R
lis �e 00 -
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires as
'to
e!!A'
permit construct,. alter, improve, demolish, or repair any structure, 'prior to its. issuance also -
'• -
-requires the applicant -for such permit to rite a signed statement that he is -licensed pursuant to
PERMIT -
AMOUNT
the provisions of the Contractor's License Law, Chapter -9 (commencing with Section 7000) of
' Division 3 of the Business and Professions Code, or th&-he 'is exempt'theiefrom, and the basis
--
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
. Plan.Chk. Dep.'.
subjects the applicant to a civil penalty of not more than five hundred dollars'($500).
Plan Chk. BBI.
2 49
„ q I, as. owner of the property, or my employees with wages as their sole compensation, will
•
do the work, and the structure is not intended or offered for sale. (Seca 7044, Buisness and '
COnSt.
l> 00
. Professions Code:' The Contractor's License Law does not apply to ;an owner of property .who
•
builds or improves thereon and who does such work himself or through his own employees,
Mech. -
3434.00provided.
that' such improvements are not intended or offered for sale. If, however, the building
�.
or improvement is sold -within one year of completion, the • owner -builder will have the burden
Electrical
rte•.��
of proving that he did not build or improve for the purpose of sale.) .
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
1%e>t�
struct the project. (Sec: 7044, -Business- and Professions Code: The Contractor's License Law
_
-
does not apply to an owner of property who builds. or improves thereon; and who contracts for
S.M.I. '
- - 6.62
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
Grading
❑ I am exempt under Sec.. B. & P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure
3,413.66
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have 'a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
' Policy No. ' Company
❑ Copy,is filed with the city.. ❑ Certified copy is hereby furnished.
TOTAL
2,352.2
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.) '
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the 'Workers' Compensation provisions of. the Labor' Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. '
CONSTRUCTION LENDING AGENCY.
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.) .
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all 'city and county ordinances and state laws relating to building
construction, and hereby authorize representatives' -of this city to enter the above ,
mentioned property for inspection' purposes. 1
Signature of applicant _ Dale )F
Mailing Address f
City, State, Zip i
HARD COPYI
HtMAHKJ
ZONE: I BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date 2" i Permit
Validated by:
Validation:
A 7 2 6 4 2 6 6 Z 2 6 U
CONSTRUCTION ESTIMATE
NO. ELECTRICAL EE2111111L
NO. PLUMBING FEES
1ST FL. SQ. FT. ® smw
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT. ®'
WALL SQ. FT. p
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
4f&OUGH PLUMB. —,�/*C
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
Q AS (ROUGH) — g 7
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
KITCHEN SINK .
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
INAL INSP. C -11—F9
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEEMECH.FEE
PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
5 ` SETBACK ,.1 dF�
ROUND PLUM BI
UNDERGROUND
A.C. UNIT
COLL. AREA
'( t-LILSLAB GRADE
4f&OUGH PLUMB. —,�/*C
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS /3��SEWER
rl
OR SEPTIT 71
OUGH WIRINGI/-2/
O`
,7
DUCT WORK
ROCK STORAGE
!U—/FOUND. REINF. , ��7
Q AS (ROUGH) — g 7
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
11,C-REINF. STEEL 3-7 5
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
INAL INSP. 6'_11 -79
BOND BEAM
WATER SYSTEM
GRADING
CU.Y d.
$ plus x$ = $
LUMBER GR.
INAL INSP. l! —�
Al FRAMING /�� � —�
INAL INSP. C -11—F9
ROOFINGj/,,Cr,e
(ye TQ �
uJ N=
A/O
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
�C�NSULATION/SOUND
FINISH GRADING
✓1 INAL INSPECTION n. —G 7
// O
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL